Individual
BENNIE B. ALDERDICE SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
100 HARDIN LN, SUITE B, SOMERSET, KY 42503-3812
(606) 679-8568
(606) 676-0868
Mailing address
100 HARDIN LN, SUITE B, SOMERSET, KY 42503-3812
(606) 679-8568
(606) 676-0868
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4939
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
4939
KY
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
4939
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000048337
ANTHEM BC/BS
KY
01
—
0041586
BC/BS OF TN.
TN
01
—
4300039
UNITED HEALTHCARE MEDICAL
KY
01
—
5004539
PASSPORT
KY
05
—
60049392
—
KY
01
—
63437-1
UNITED HEALTHCARE DENTAL
KY
05
—
64049398
—
KY
Enumeration date
07/31/2006
Last updated
12/27/2017
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